Perceptions of the influence of prescription medicine samples on prescribing by family physicians

Background: The provision of free prescription medicine samples is a common and traditional marketing strategy used by pharmaceutical companies, but concerns have been raised about their influence on physician prescribing behavior and patient safety. Objective: We sought to investigate the knowledge, attitudes, and behaviors of Australian family physicians regarding the use of sample prescription medications. Methods: Qualitative and quantitative techniques were used, including (1) mailed questionnaires to family physicians, (2) semistructured interviews with family physicians, and (3) sample cupboard inventories. Results: A number of issues about samples were identified by the questionnaires (208) and interviews (17 doctors), including insufficient labeling, poor record keeping, diversion of stock (personal use by doctors.. their families, practice staff and pharmaceutical representatives), and wasting of expired stock. Prescription medicine samples also influenced prescribing behavior. Australian doctors were less likely to provide samples to patients on financial grounds compared with a previous study in the United States on medical residents. Six sample cupboards were inventoried. Median wholesale value of sample cupboards was AUD $4959 (range $2395-$8709), with 6% of stock expired. Very little generic medicine was included in the sample cupboards. Conclusions: Better methods are needed to meet legislative requirements and to ensure quality use of medicines (and optimal public health) with respect to prescription medicine samples. Doctors and practice staff require training on the appropriate handling and storage of prescription medications. Alternative ways for distribution of sample medications need to be investigated.

Laboratory evaluation of the effect of alternative prey and vegetation on predation of Culex annulirostris immatures by Australian native fish species

The impact of alternative prey and simulated vegetation on Culex annulirostris Skuse predation efficacy by Australian smelt, Retropinna semoni (Retropinnidae); crimson-spotted rainbowfish, Melanotaenia duboulayi (Melanotaeniidae); empire gudgeon, Hypseleotris compressa (Eleotridae); estuary perchlet, Ambassis marianus (Ambassidae); firetail gudgeon, Hypseleotris galii (Eleotridae); fly-specked hardyhead, Craterocephalus stercusmuscarum (Atherinidae); and Pacific blue-eye, Pseudomugil signifer (Atherinidae), was evaluated in Queensland, Australia. The presence of chironomid midge larvae and tusked frog, Adelotus brevis (Leptodactylidae), tadpoles did not have a significant negative impact on the predation rates of Cx. annulirostris by these 7 fish species. Hypseleotris galii, M. duboulayi, and R. semoni demonstrated strong preference for larvae of Cx. annulirostris over both alternative prey species. In the presence of alternative prey species, the mean predation rate of M. duboulayi on larvae of Cx. annulirostris remained greater than that of other fish species tested. When evaluated at varying densities of simulated vegetation, predation rates of all fish species were similar to those reported in open conditions.

Muscle glycogen inharmoniously regulates glycogen synthase activity, glucose uptake, and proximal insulin signaling

Muscle glycogen inharmoniously regulates glycogen synthase activity, glucose uptake, and proximal insulin signaling. Am J Physiol Endocrinol Metab 290: E154-E162, 2006. First published August 23, 2005; doi:10.1152/ajpendo. 00330.2005.-Insulin-stimulated glucose uptake and incorporation of glucose into skeletal muscle glycogen contribute to physiological regulation of blood glucose concentration. In the present study, glucose handling and insulin signaling in isolated rat muscles with low glycogen (LG, 24-h fasting) and high glycogen (HG, refed for 24 h) content were compared with muscles with normal glycogen (NG, rats kept on their normal diet). In LG, basal and insulin-stimulated glycogen synthesis and glycogen synthase activation were higher and glycogen synthase phosphorylation (Ser645, Ser649, Ser653, Ser657) lower than in NG. GLUT4 expression, insulin-stimulated glucose uptake, and PKB phosphorylation were higher in LG than in NG, whereas insulin receptor tyrosyl phosphorylation, insulin receptor substrate-1-associated phosphatidylinositol 3-kinase activity, and GSK-3 phosphorylation were unchanged. Muscles with HG showed lower insulin-stimulated glycogen synthesis and glycogen synthase activation than NG despite similar dephosphorylation. Insulin signaling, glucose uptake, and GLUT4 expression were similar in HG and NG. This discordant regulation of glucose uptake and glycogen synthesis in HG resulted in higher insulin-stimulated glucose 6-phosphate concentration, higher glycolytic flux, and intracellular accumulation of nonphosphorylated 2-deoxyglucose. In conclusion, elevated glycogen synthase activation, glucose uptake, and GLUT4 expression enhance glycogen resynthesis in muscles with low glycogen. High glycogen concentration per se does not impair proximal insulin signaling or glucose uptake. Insulin resistance is observed at the level of glycogen synthase, and the reduced glycogen synthesis leads to increased levels of glucose 6-phosphate, glycolytic flux, and accumulation of nonphosphorylated 2-deoxyglucose.

Contribution of potential yield, drought tolerance and escape to adaptation of 15 rice varieties in rainfed lowlands in Cambodia

In Cambodia, grain yield in rainfed lowland rice is often affected by drought during late vegetative or reproductive stage. Several experiments were conducted to quantify the contribution of potential yield, drought tolerance and drought escape mechanisms to yield under water stress conditions. In total nine pairs of well irrigated and simulated drought (by draining water) experiments were conducted. Potential yield was obtained under irrigation. Grain yields and flowering dates were recorded in 15 varieties. Drought tolerance was quantified by using drought response index (DRI), which is grain yield under drought adjusted for potential yield and flowering date of the variety. Drought escape is expressed as days to flower under drought conditions. Mean yield reduction due to drought of nine experiments was 27 % (range 12-44). The relative contribution of yield potential, flowering date and DRI to observe yield under drought were evaluated by multiple regression for each experiment. Potential yield accounted for 54% (with a range of 10-80) of the variation in actual yield under drought. This was followed by DRI and flowering date with 34 (with a range of 0-60) and 12 (with a range of 0-30) of the contribution, respectively. It is concluded that selecting for drought tolerance as well as for high yield potential would be important in developing cultivars for rainfed lowlands in Cambodia. Although flowering dates are important for drought escape, it had a small contribution probably because drought developed slowly in these experiments in Cambodia.

Study on the pyrolytic behaviour of xylan-based hemicellulose using TG-FTIR and Py-GC-FTIR

Two sets of experiments, categorized as TG–FTIR and Py–GC–FTIR, are employed to investigate the mechanism of the hemicellulose pyrolysis and the formation of main gaseous and bio-oil products. The “sharp mass loss stage” and the corresponding evolution of the volatile products are examined by the TG–FTIR graphs at the heating rate of 3–80 K/min. A pyrolysis unit, composed of fluidized bed reactor, carbon filter, vapour condensing system and gas storage, is employed to investigate the products of the hemicellulose pyrolysis under different temperatures (400–690 °C) at the feeding flow rate of 600 l/h. The effects of temperature on the condensable products are examined thoroughly. The possible routes for the formation of the products are systematically proposed from the primary decomposition of the three types of unit (xylan, O-acetylxylan and 4-O-methylglucuronic acid) and the secondary reactions of the fragments. It is found that the formation of CO is enhanced with elevated temperature, while slight change is observed for the yield of CO2 which is the predominant products in the gaseous mixture.

Flow field analysis of some mixing and conveying screw element regions, within a closely intermeshing, co-rotating twin-screw extruder.

Grafting of antioxidants and other modifiers onto polymers by reactive extrusion, has been performed successfully by the Polymer Processing and Performance Group at Aston University. Traditionally the optimum conditions for the grafting process have been established within a Brabender internal mixer. Transfer of this batch process to a continuous processor, such as an extruder, has, typically, been empirical. To have more confidence in the success of direct transfer of the process requires knowledge of, and comparison between, residence times, mixing intensities, shear rates and flow regimes in the internal mixer and in the continuous processor.The continuous processor chosen for the current work in the closely intermeshing, co-rotating twin-screw extruder (CICo-TSE). CICo-TSEs contain screw elements that convey material with a self-wiping action and are widely used for polymer compounding and blending. Of the different mixing modules contained within the CICo-TSE, the trilobal elements, which impose intensive mixing, and the mixing discs, which impose extensive mixing, are of importance when establishing the intensity of mixing. In this thesis, the flow patterns within the various regions of the single-flighted conveying screw elements and within both the trilobal element and mixing disc zones of a Betol BTS40 CICo-TSE, have been modelled using the computational fluid dynamics package Polyflow. A major obstacle encountered when solving the flow problem within all of these sets of elements, arises from both the complex geometry and the time-dependent flow boundaries as the elements rotate about their fixed axes. Simulation of the time dependent boundaries was overcome by selecting a number of sequential 2D and 3D geometries, used to represent partial mixing cycles. The flow fields were simulated using the ideal rheological properties of polypropylene and characterised in terms of velocity vectors, shear stresses generated and a parameter known as the mixing efficiency. The majority of the large 3D simulations were performed on the Cray J90 supercomputer situated at the Rutherford-Appleton laboratories, with pre- and postprocessing operations achieved via a Silicon Graphics Indy workstation. A mechanical model was constructed consisting of various CICo-TSE elements rotating within a transparent outer barrel. A technique has been developed using coloured viscous clays whereby the flow patterns and mixing characteristics within the CICo-TSE may be visualised. In order to test and verify the simulated predictions, the patterns observed within the mechanical model were compared with the flow patterns predicted by the computational model. The flow patterns within the single-flighted conveying screw elements in particular, showed good agreement between the experimental and simulated results.

Some aspects of the microbiological properties of polymers and composite materials

The interaction of microorganisms with glass-reinforced polyester resins(GRP), both under laboratory and simulated operating conditions, has been examined following reports of severl! fungal biodeterioration. Although GRP was not previously associated with substantial microbial growth, small amounts of microbial activity would pose problems for products associated with comestible materials. The microbiology of the raw materials was investigated, two ingredients were supportive to microbial populations whilst five materials were biostatic or inhibitory in their action. Production laminate was not susceptible to microbial deterioration or inhibitory to microbes. Incorporation of zinc stearate, one of the supportive ingredients, at 300% manufacturing level or drastic undercuring produced laminate capable of supporting microbial growth but only after a non-biotic stage of degradation. Study of the long-term population dynamics of cisterns of GRP and competitive materials under conditions simulating in-service conditions, monitoring microbial numbers within the experimental vessels and comparing with the populations of the supply water, suggests that the performance of GRP cisterns is slightly superior to conventional competitive materials. An investigation of the biological performance of GRP cisterns in an isolated area of known microbiological hazard was conducted. Severe biodeterioration had been experienced with Preform GRP articles moulded using different production techniques, but substitution of current GRP articles resulted in no recurrence of the problem. All attempts to establish the fungal isolate responsible for the phenomena in cisterns under controlled conditions failed. Scanning Electron Microscopy of GRP surfaces showed that although differences exist between current and Preform laminates, these could not satisfactorily explain the differences in service behaviour. These results and the results of the British Plastics Federation Expert Working Group interlaboratory study are discussed in relation to the original report of gross fungal biodeterioration and, to the design of future testing programmes for the products of industrial concerns.

Investigations of the site and mechanisms of drug-induced reductions in the reabsorption of divalent cations by the kidney

Disturbances in electrolyte homeostasis are a frequent adverse side-effect of the administration of aminoglycoside antibiotics such as gentamicin, and the antineoplastic agent cis-platinum. The aims of this work were to further elucidate the site(s) and mechanism(s) by which these drugs may produce disturbances in the renal reabsorption of calcium and magnesium. These investigations were undertaken using a range of in vivo and in vitro techniques and models. Initially, a series of in vivo studies was conducted to delineate aspects of the acute and chronic effects of both drugs on renal electrolyte handling and to select and evaluate an appropriate animal model: subsequent investigations were focused on gentamicin. In a study of the acute and chronic effects of cis-platinum administration, there were pronounced acute changes in a variety of indices of nephrotoxic injury, including electrolyte excretion. Most effects resolved but there were chronic increases in the urinary excretion of calcium and magnesium. The renal response of three strains of rat (Fischer 344, Sprague-Dawley (SD), and Wistar) to a ranges of doses of gentamicin was also investigated. Drug administration produced substantially different responses between strains, in particular marked differences in calcium and magnesium excretion. The results suggested that the SD rat was an appropriately sensitive strain for use in further investigations. Acute infusion of gentamicin in the anaesthetised SD rat produced rapid, substantial increases in the fractional excretion of calcium and magnesium, while sodium and potassium output were unaffected, confirming previous results of similar experiments using F344 rats. Studies using lithium clearance measurements in the anaesthetised SD rat were undertaken to investigate the effects of gentamicin on proximal tubular calcium reabsorption. Lithium clearance was unaffected by acute gentamicin infusion, suggesting that the site of acute gentamicin-induced hypercalciuria may not be located in the proximal tubule. Inhibition of Ca2+ ATPase activity was investigated as a potential mechanism by which calcium reabsorption could be affected after aminoglycoside administration. In vitro, both Ca2+ ATPase and Na+/K+ ATPase activity could be similarly inhibited by the presence of aminoglycosides, in a dose-related manner. Whilst inhibition of Na+/K+ ATPase could be demonstrated biochemically after in vivo administration of gentamicin, there were no concurrent effects on Ca2+ ATPase activity, suggesting that inhibition of Ca2+ ATPase activity is unlikely to be a primary mechanism of aminoglycoside-induced reductions of calcium reabsorption. Histochemical studies could not discern inhibition of either Na+/K+ ATPase or Ca2+ ATPase activity after in vivo administration of gentamicin. Selection of renal cell lines for further investigative in vitro studies on the mechanisms of altered cation reabsorption was considered using MTT (3-(4,5,-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) and Neutral Red cytotoxicity assays. The ability of LLC-PK1 and LLC-RK1 cell lines to correctly rank a series of nephrotoxic compounds with their known nephrotoxic potency in vivo was studied. Using these cell lines grown on semi-permeable inserts, alterations in the paracellular transport of 45Ca was investigated as a possible mechanism by which gentamicin could alter calcium reabsorption in vivo. Short term exposure (I h) of LLC-RK1 cells to gentamicin, via both cell surfaces, resulted in a reduction in paracellular permeability to both transepithelial 3H-mannitol and 45Ca fluxes. When LLC-RK1 cells were exposed via the apical surface only, similar dose-related reductions were seen to those observed when cells were exposed to the drug from both sides. Short-term basal exposure to gentamicin appeared to contribute less to the observed reductions in 3H-mannitol and 45Ca fluxes. Experiments investigating transepithelial movement of 45Ca and 3H-mannitol on LLC-PK1 cells after acute gentamicin exposure were inconclusive. Longer exposure (48 h) to gentamicin caused an increase in the permeability of the monolayer and a consequent increase in transepithelial 45Ca flux in the LLC-RK1 cell line; increases in permeability of LLC-PK1 cells to 45Ca and 3H-mannitol were not apparent under the same conditions. The site and mechanism at which gentamicin, in particular, alters calcium reabsorption cannot be definitively described from these studies. However, indirect evidence from lithium clearance studies suggests that the site of the lesion is unlikely to be located in the proximal tubule. The mechanism by which gentamicin exposure alters calcium reabsorption may be by reducing paracellular permeability to calcium rather than by altering active calcium transport processes.

Implementation challenges of application of radio frequency identification (RFID) in warehouse

Warehouse is an essential component in the supply chain, linking the chain partners and providing them with functions of product storage, inbound and outbound operations along with value-added processes. Allocation of warehouse resources should be efficient and effective to achieve optimum productivity and reduce operational costs. Radio frequency identification (RFID) is a technology capable of providing real-time information about supply chain operations. It has been used by warehousing and logistic enterprises to achieve reduced shrinkage, improved material handling and tracking as well as increased accuracy of data collection. However, both academics and practitioners express concerns about challenges to RFID adoption in the supply chain. This paper provides a comprehensive analysis of the problems encountered in RFID implementation at warehouses, discussing the theoretical and practical adoption barriers and causes of not achieving full potential of the technology. Lack of foreseeable return on investment (ROI) and high costs are the most commonly reported obstacles. Variety of standards and radio wave frequencies are identified as source of concern for decision makers. Inaccurate performance of the RFID within the warehouse environment is examined. Description of integration challenges between warehouse management system and RFID technology is given. The paper discusses the existing solutions to technological, investment and performance RFID adoption barriers. Factors to consider when implementing the RFID technology are given to help alleviate implementation problems. By illustrating the challenges of RFID in the warehouse environment and discussing possible solutions the paper aims to help both academics and practitioners to focus on key areas constituting an obstacle to the technology growth. As more studies will address these challenges, the realisation of RFID benefits for warehouses and supply chain will become a reality.

Myopia control with orthokeratology contact lenses in Spain:a comparison of vision-related quality-of-life measures between orthokeratology contact lenses and single-vision spectacles

Purpose: To compare vision-related quality-of-life measures between children wearing orthokeratology (OK) contact lenses and distance single-vision (SV) spectacles. Methods: Subjects 6 to 12 years of age and with myopia of -0.75 to -4.00 diopters and astigmatism less than or equal to 1.00 diopters were prospectively assigned OK contact lens or SV spectacle correction. A pediatric refractive error profile questionnaire was administered at 12- and 24-month intervals to evaluate children's perceptions in terms of overall vision, near vision, far distance vision, symptoms, appearance, satisfaction, activities, academic performance, handling, and peer perceptions. The mean score of all items was calculated as the overall score. Additionally, parents/guardians were asked to rate their child's mode of visual correction and their intention to continue treatment after study completion. Results: Thirty-one children were fitted with OK contact lenses and 30 with SV spectacles. Children wearing OK contact lenses rated overall vision, far distance vision, symptoms, appearance, satisfaction, activities, academic performance, handling, peer perceptions, and the overall score significantly better than children wearing SV spectacles (all P<0.05). Near vision and handling were, respectively, rated better (P<0.001) and similar (P=0.44) for SV spectacles in comparison to OK contact lenses. No significant differences were found between 12 and 24 months for any of the subjective ratings assessed (all P>0.05). Parents/guardians of children wearing OK contact lenses rated visual correction method and intention to continue treatment higher than parents of children wearing SV spectacles (P=0.01). Conclusion: The results indicate that the significant improvement in vision-related quality of life and acceptability with OK contact lenses is an incentive to engage in its use for the control of myopia in children.

Silica-clad neodymium-doped lanthanum phosphate fibers and fiber lasers

We have fabricated a neodymium-doped phosphate glass fiber with a silica cladding and used it to form a fiber laser. Phosphate and silicate glasses have considerably different glass transition temperatures and softening points making it hard to draw a fiber from these two glasses. A bulk phosphate glass of composition (Nd2O3)(0.011)(La2O3)(0.259)(P2O5)(0.725)(Al2O3)(0.005) was prepared and the resultant material was transparent, free from bubbles and visibly homogeneous. The bulk phosphate glass was drawn to a fiber while being jacketed with silica and the resultant structure was of good optical quality, free from air bubbles and major defects. The attenuation at a wavelength of 1.06 mu m was 0.05 dB/cm and the refractive index of the core and cladding at the pump wavelength of 488 nm was 1.56 and 1.46, respectively. The fibers were mechanically strong enough to allow for ease of handling and could be spliced to conventional silica fiber. The fibers were used to demonstrate lasing at the F-4(3/2) - I-4(11/2) (1.06 mu m) transition. Our work demonstrates the potential to form silica clad optical fibers with phosphate cores doped with very high levels of rare-earth ions (27-mol % rare-earth oxide).

The effect of bioglass addition on mechanical and physical properties of photoactive UDMA-TEGDMA resin composites

Light curable dimethacrylate resin composites undergo free radical photopolymerisation in response to blue light (wavelength 450-500 nm) and may offer superior handling and setting characteristics for novel hard tissue repair materials. The current investigation aims to determine the optimum formulation of bisphenol-A glycidyl methacrylate and triethyleneglycoldimethacrylate (bisGMA/TEGDMA) or urethane dimethacrylate (UDMA)/TEGDMA resin mixtures and the effect of Bioglass incorporation on the rate of polymerisation (RP), degree of conversion (DC) and flexural strength (FS) of light-curable filled resin composites (FRCs). Experimental photoactive resins containing a range of bisGMA, UDMA and TEGDMA ratios and/or filled with non-silanised irregular or spherical 45S5-Bioglass (50 μm; 5-40 wt%) and/or silanised silicate glass filler particulates (0.7 μm; 50-70 wt%) were tested. RP and DC were analysed in real-time using nearinfrared spectroscopy. FS of resins and FRCs were determined using three-point flexural strength tests. UDMA/TEGDMA resins exhibited increased DC compared with bisGMA/TEGDMA resins (p<0.05). The addition of spherical particles of Bioglass had a detrimental effect on the FS (p>0.05), whereas they increased DC of UDMA/TEGDMA resins (p<0.05). Addition of irregular shaped Bioglass particles increased the FS of UDMA/TEGDMA resins up to 20 wt% Bioglass (p<0.05). The flexibility and strength conferred by the urethane group in UDMA may result in enhanced physical and mechanical properties compared with conventional resins containing bulky (bisGMA) molecules. Addition of 45S5-Bioglass with specific filler content, size and morphology resulted in enhanced mechanical and physical properties of UDMA/TEGDMA composites. © (2014) Trans Tech Publications, Switzerland.

Density forecasts of crude-oil prices using option-implied and ARCH-type models

The predictive accuracy of competing crude-oil price forecast densities is investigated for the 1994–2006 period. Moving beyond standard ARCH type models that rely exclusively on past returns, we examine the benefits of utilizing the forward-looking information that is embedded in the prices of derivative contracts. Risk-neutral densities, obtained from panels of crude-oil option prices, are adjusted to reflect real-world risks using either a parametric or a non-parametric calibration approach. The relative performance of the models is evaluated for the entire support of the density, as well as for regions and intervals that are of special interest for the economic agent. We find that non-parametric adjustments of risk-neutral density forecasts perform significantly better than their parametric counterparts. Goodness-of-fit tests and out-of-sample likelihood comparisons favor forecast densities obtained by option prices and non-parametric calibration methods over those constructed using historical returns and simulated ARCH processes. © 2010 Wiley Periodicals, Inc. Jrl Fut Mark 31:727–754, 2011

Self-phase modulation dependent dispersion mitigation in high power SSB and DSB + dispersion compensated modulated radio-over-fiber links

The joint effect of fiber chromatic dispersion and fiber nonlinearity onto single-sideband and double-sideband modulated radio-over-fiber links is investigated. Experimental and simulated results show that modulation suppression caused by the chromatic dispersion in radio-over-fiber links can be successfully eliminated in both schemes only when the system is in the linear regime. Under nonlinear transmission the received microwave carrier power depends on the optical incident power.

Identification and relative quantification of tyrosine nitration in a model peptide using two-dimensional infrared spectroscopy

Nitration of tyrosine in proteins and peptides is a post-translational modification that occurs under conditions of oxidative stress. It is implicated in a variety of medical conditions, including neurodegenerative and cardiovascular diseases. However, monitoring tyrosine nitration and understanding its role in modifying biological function remains a major challenge. In this work, we investigate the use of electron-vibration-vibration (EVV) two-dimensional infrared (2DIR) spectroscopy for the study of tyrosine nitration in model peptides. We demonstrate the ability of EVV 2DIR spectroscopy to differentiate between the neutral and deprotonated states of 3-nitrotyrosine, and we characterize their spectral signatures using information obtained from quantum chemistry calculations and simulated EVV 2DIR spectra. To test the sensitivity of the technique, we use mixed-peptide samples containing various levels of tyrosine nitration, and we use mass spectrometry to independently verify the level of nitration. We conclude that EVV 2DIR spectroscopy is able to provide detailed spectroscopic information on peptide side-chain modifications and to detect nitration levels down to 1%. We further propose that lower nitration levels could be detected by introducing a resonant Raman probe step to increase the detection sensitivity of EVV 2DIR spectroscopy. (Graph Presented).